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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. News Article
    Parkinson’s patients are suffering from “devastating effects” as GPs have started to switch to cheaper drugs which have different release rates into the body. Parkinson’s UK put out a warning when a 65-year-old man who had been successfully managing the condition for 17 years suddenly needed help eating and getting dressed. This happened after his branded medication Sinemet was changed to a cheaper form of the drug. Barrie Smith - who comes from Birmingham - was left in pain, developed slow speech and experienced an uncontrolled tremor when his normal Sinemet medication was switched to a more generic form of medication last year without consultation. He called the effects “devastating”. Dr Rowan Wathes, Associate Director of the Parkinson’s Excellence Network at Parkinson’s UK, said: “Changes to brands or manufacturers can trigger a significant deterioration of symptoms. It is vitally important for prescribers to specify the Parkinson’s medication brand or generic manufacturer on prescriptions for people with Parkinson’s. ” Read full story Source: The Independent, 30 January 2023 You may also be interested in the following blogs written by Parkinson's UK for the hub: Medication delays: A huge risk for inpatients with Parkinson’s Keeping patients with Parkinson’s safe in hospital: 4 key actions for staff Preparing to go into hospital – tips for people with Parkinson's and their carers
  2. News Article
    Trusts are getting better at coping with industrial action and are still on track to hit the national target of eliminating the backlog of 78-week waiters, an NHS England director has told staff. Paul Doyle, NHS England’s programme director for elective recovery, said: “We continue to make really good progress [on elective recovery]… we are very much in the end game now of meeting the 78-week ambition for the end of March.” There have been concerns about the impact of recent strike action on eliminating the 78-week backlog, but Mr Doyle praised managers’ handling of the strikes and said administrative staff were doing an “incredible job”. He added: “Most organisations affected have got better and better as time has gone on about making sure that there are as few cancellations as possible and that cancellations are rebooked quickly or that clinical time is put to good use such as doing virtual outpatient appointments or doing validation of waiting list.” Read full story (paywalled) Source: HSJ, 30 January 2023
  3. News Article
    Artificial hip and knee joints that have to be removed after failing early are to be examined routinely to save the NHS £200million a year – and reduce unnecessary pain for patients in future. Less than 1 in 100 removed implants are examined to see why they failed, so surgeons don’t learn what went wrong or pick up on potential scandals. Consultant orthopaedic surgeon Raghavendra Sidaginamale, of North Tees and Hartlepool NHS Trust, said: "Most removed implants are put in the bin. A wealth of information goes down the drain." Now the NHS is setting up an Implants Analysis Service, enabling hospitals to send them off to be analysed for signs of unusual wear or chemical degradation. Each year, 15,000 hip and knee replacements are replaced. If this happens within ten years, they are deemed to have failed early. Jason Wilson, of the IAS, said they are ‘like a black box flight recorder in a plane’, adding: "They hold a wealth of information we can learn from." Read full story Source: Daily Mail, 29 January 2023
  4. Content Article
    Health workers, hailed as heroes during the pandemic, say they’re being abandoned by the NHS and the government. Some are living with Long Covid and say it’s having a devastating impact on both their personal and professional lives. For Panorama, the BBC’s health correspondent, Catherine Burns, meets staff struggling to return to work and reveals how some are now facing financial hardship and the prospect of having to retire early or, worse, being sacked.
  5. News Article
    More than half a million patients a year will be treated in “hospitals at home” in an attempt to relieve pressure on A&E departments. Under the plans, elderly and frail patients who fall will be treated by video link, with ministers saying that a fifth of emergency admissions could be avoided with the right care. Health officials said the “virtual wards” would be backed up by £14 billion in extra spending on health and care services over the next two years, as the NHS tackles record backlogs, with seven million people on waiting lists. Rishi Sunak said the Urgent & Emergency Care Recovery Plan showed that the NHS was one of his “top priorities”. Read full story (paywalled) Source: The Telegraph, 29 January 2023
  6. News Article
    The National Crime Agency and Interpol has been drafted in by detectives investigating a junior doctor accused of multiple sexual assaults on children and adults in A&E departments. Last year, Staffordshire police began an investigation into a 35-year-old medic's work at two hospitals, the Royal Stoke University Hospital in Staffordshire and the Russells Hall Hospital in Dudley, West Midlands. Source: Sunday Times Shared by Shaun Lintern Tweet, 29 January 2023
  7. News Article
    Erik, a 26-year-old Seattle grocery clerk, who also has attention-deficit hyperactivity disorder (ADHD), has been unable to get his medications filled for months now – and he’s worried he’ll lose the first full-time job he’s ever had. For people like Erik, ADHD medication is a prerequisite for basic functioning – and over the last year it’s become dramatically harder for patients like them to access care. Last October, the Food and Drug Administration (FDA) announced a shortage of Adderall, one of the most common stimulant medications for ADHD. In recent months, patients have reported problems filling nearly every type of ADHD medication. What’s stranger is that no one seems to know why. Is it some kind of supply chain issue? A pandemic-era surge in demand? A government crackdown? Official explanations have offered little clarity. The FDA’s announcement mentioned “intermittent manufacturing delays” at Teva, the producer of the branded version of Adderall, but few other details. The American Society of Health Pharmacists reports shortages of multiple ADHD drugs but says manufacturers have given no explanation. The situation has left patients in turmoil. Read full story Source: The Guardian, 30 January 2023
  8. News Article
    The government’s target for England to become smoke-free by 2030 – which integrated care systems are expected to pursue – is being undermined by the unavailability of two smoking cessation medicines. The objective, set by government in 2019, is being taken forward by many ICSs, as they seek to prevent premature illness and death, and narrow health inequalities, with smoking rates normally higher in more deprived populations. However HSJ analysis of drug shortages revealed that the two cessation medicines are both currently unavailable for an extended period. Champix (varenicline) has been unavailable since October 2021, a situation exacerbated by the absence of Zyban (bupropion), since December 2022. Both drugs were withdrawn because of concerns about the presence of nitrosamines, which may increase risk of cancer if people are exposed to them above acceptable levels, and will be subject to further tests and regulatory checks if they are to return. Matthew Evison, a lung cancer and tobacco dependency specialist at Manchester University Foundation Trust, said Champix was clinicians’ “most powerful weapon” against smoking. He said the treatment gap would make the target harder because “smoking prevalence declines will be slower without varenicline”. Read full story Source: HSJ, 30 January 2023
  9. Content Article
    Young people from across the UK reflect on how the pandemic is still affecting their lives and their plans for the future, 18 months after the end of the third national lockdown.
  10. Event
    until
    This Westminster Health Forum conference will focus on next steps for pharmacy services in healthcare delivery, and opportunities to develop the role of community pharmacy as part of the health service in England. It comes amidst proposals to increase prescribing powers for pharmacists and reform training to enable pharmacists to work as independent prescribers immediately following graduation, as well as the Health Secretary announcing additional pharmacy services within the Primary Care Recovery Plan, and also indicating that implementation of a Pharmacy First system in England is being considered. The conference takes place against the backdrop of an evolving healthcare landscape, including developments in integrated care systems and digital transformation, an expected update to the NHS Long Term Plan, and wider strategic initiatives to implement alternatives to medicine, such as the Overprescribing Review. We expect discussion on opportunities to develop pharmacy services as a key component of future NHS and community care delivery. It will include keynote sessions with Gisela Abbam, Chair, General Pharmaceutical Council; Andrew Lane, Chair, National Pharmacy Association; Matthew Armstrong, Senior Manager, Pharmacy Contracts and Project Developments, Walgreens Boots Alliance; and a senior speaker confirmed from the Professional Record Standards Body. Overall, areas for discussion include: strategic ambitions: the opportunity for a Pharmacy First scheme in England - long-term aims for pharmacy services in the context of an updated NHS Long Term Plan. community pharmacy: future role in improvements to key service areas such as general practice, primary care and the ambulance service - delivering medicine optimisation in community care. the workforce: priorities for upskilling - improving training to increase the number of independent prescribers and develop the services that pharmacists can offer. digital pharmacy: key areas for expansion - supporting efficiency in prescription management - potential for digital services to allow patients more control over their care. further development areas: social prescribing services and non-medical treatments - the NHS STOMP programme - structured medicine reviews to support reduction of overprescribing. Register
  11. News Article
    The NHS faces an alarming mass exodus of doctors and dental professionals, health chiefs have said, as a report reveals 4 in 10 are likely to quit over “intolerable” pressures. Intense workloads, rapidly soaring demand for urgent and emergency healthcare and the record high backlog of operations are causing burnout and exhaustion and straining relationships between medics and patients, according to the report by the Medical Defence Union (MDU), which provides legal support to about 200,000 doctors, dental professionals and other healthcare workers in the UK. In an MDU survey of more than 800 doctors and dental professionals across the UK, conducted within the last month and seen by the Guardian, 40% agreed or strongly agreed they were likely to resign or retire within the next five years as a direct result of “workplace pressures”. Medical leaders called the report “deeply concerning”. There are already 133,000 NHS vacancies in England alone. NHS chiefs said it laid bare the impact of the crisis in the health service on staff, and MPs said it should serve as a “wake-up call” to ministers on the urgent need to take action to persuade thousands of NHS staff heading for the exit door to stay. Read full story Source: The Guardian, 29 January 2023
  12. News Article
    Thousands of NHS staff across the UK are facing pay cuts because of a change in Covid sickness policy. Analysis by BBC Panorama suggests that between 5,000 and 10,000 NHS workers could be off sick with Long Covid. Unions are accusing the government of failing to support health staff who worked during the coronavirus pandemic. The government says the Covid-19 public inquiry will examine these issues when it begins taking evidence in May. Changes to special sick pay rules introduced during the pandemic mean that some NHS staff unable to work due to Long Covid may soon no longer receive full pay. Enhanced provision ended last year. Many had a six-month transition, so expect their wages to go down soon. Some face losing their jobs. Professor David Strain is the chair of the Board of Science at the British Medical Association (BMA) and says this makes him "genuinely angry". He explains: "We've got a group of people that have put themselves forward to look after the population, they've been left with an illness and they're not being supported. "They're just in a no man's land." He believes that health workers with long Covid should be allowed to focus on their recovery without money worries. Read full story Source: BBC News, 30 January 2023
  13. News Article
    A highly toxic chemical compound sold illegally in diet pills is to be reclassified as a poison, a government minister has said. Pills containing DNP, or 2,4-dinitrophenol, were responsible for the deaths of 32 young vulnerable adults, said campaigner Doug Shipsey. His daughter Bethany, from Worcester, died in 2017 after taking tablets containing the chemical. The deaths were down to a "collective failure of the UK government", he said. DNP is highly toxic and not intended for human consumption. An industrial chemical, it is sold illegally in diet pills as a fat-burning substance. Experts say buying drugs online is risky as medicines may be fake, out of date or extremely harmful. Mr Shipsey said he had targeted the minister following the death of another young man who had taken the drug sold as a slimming aid. Prior to this, following the inquests of dozens of young people who had suddenly and unexpectedly died from DNP toxicity, the government had "ignored numerous coroners reports" to prevent future deaths, he said. "So, at last after 32 deaths and almost six years of campaigning, the Home Office (HO) finally accept responsibility to control DNP under the Poisons ACT 1972," he added. Read full story Source: BBC News, 28 January 2023
  14. Content Article
    To support recovery of the NHS by improving waiting times and patient experience, a joint Department of Health and Social Care (DHSC) and NHS England plan sets out a number of ambitions, including: Patients being seen more quickly in emergency departments: with the ambition to improve to 76% of patients being admitted, transferred or discharged within four hours by March 2024, with further improvement in 2024/25. Ambulances getting to patients quicker: with improved ambulance response times for Category 2 incidents to 30 minutes on average over 2023/24, with further improvement in 2024/25 towards pre-pandemic levels. NHS England has engaged with a wide range of stakeholders to develop the plan, and it draws on a diverse range of opinion and experience, as well as views of patients and users. The Department of Health and Social Care, who produced the content on actions being taken in social care, have led on engagement with the sector.
  15. News Article
    NHS England has revealed a new intervention regime, as it seeks to deliver on its new urgent and emergency care recovery plan. Systems will be placed in three “tiers of intervention”, with those systems deemed “off-target on delivery” being given “tier three intensive support” from NHSE, which will include on-the-ground planning, analytical and delivery capacity, “buddying” with leading systems and “targeted executive leadership”. The approach follows that which has been taken over the past year for elective and cancer care recovery. The urgent care plan, published by NHSE and the Department of Health and Social Care today, says: “NHS England will identify and share good practice so that all can learn from the best. For those systems that are struggling, we will offer support to ensure that they have the best opportunities to drive improvement locally.” Read full story (paywalled) Source: HSJ, 30 January 2023
  16. News Article
    Thousands of extra hospital beds and hundreds of ambulances will be rolled out in England this year in a bid to tackle the long emergency care delays. The 5,000 new beds will boost capacity by 5%, while the ambulance fleet will increase by 10% with 800 new vehicles. Details of the £1bn investment will be set out later in a joint government and NHS England two-year blueprint. Questions have also been raised about how the extra resources will be staffed - 1 in 10 posts in the NHS is vacant. The government believes the measures, which will be introduced from April, will help the NHS to start getting closer to its waiting time targets. It has set goals that by March 2024: 76% of A&E patients will be dealt with in four hours. Currently fewer than 70% are. The official target is 95% An average response time of 30 minutes for emergency calls such as heart attacks and strokes. In December patients waited over 90. The official target is 18. Prime Minister Rishi Sunak said cutting NHS waiting times was one of his five main priorities. Read full story Source: BBC News, 30 January 2023
  17. News Article
    A coroner has urged the health secretary to take action to prevent needless deaths after a woman died of heart failure following a four-hour wait in the back of an ambulance. Lyn Brind, 61, was taken to the Queen Elizabeth Hospital (QEH) in King’s Lynn, Norfolk, with chest pains and low blood oxygen levels but could not be admitted because the hospital had “no space”. Instead she remained in a queue of ambulances outside A&E without a timely diagnosis or treatment and where warning signs about her condition were missed. It was only after four hours and 25 minutes of waiting that she was transferred to a ward, by which time she was “agitated and short of breath”. She was placed on life support but died 22 minutes later. Brind’s family believe the grandmother of four, a former dinner lady from the town, “might still be alive today” had she been admitted more swiftly. “She wasn’t given a chance,” her partner of 38 years, Richard Bunton, said. After an inquest earlier this month into Brind’s death in May 2022, the senior coroner for Norfolk, Jacqueline Lake, took the unusual step of writing to England’s health secretary, Steve Barclay, to raise concerns about the NHS and social care. She warned that others could die in similar circumstances unless action was taken. “I believe you have the power to take such action,” Lake wrote in a prevention of future deaths report. Read full story Source: The Guardian, 29 January 2023
  18. Content Article
    Eurocontrol’s HindSight magazine is a magazine on human and organisational factors in operations, in air traffic management and beyond. This issue is on the theme of Handling Surprises: Tales of the Unexpected. You will find a diverse selection of articles from frontline staff, senior managers, and specialists in operations, human factors, safety, and resilience engineering in the context of aviation, healthcare, maritime and web operations. The articles reflect surprise handling by individuals, teams and organisations from the perspectives of personal experience, theory, research and training. 
  19. News Article
    The UK health department was forced to write down £14.9bn worth of personal protective equipment and other medical items, according to a report by the independent public spending watchdog, which also issued a scathing criticism of the UK Health Security Agency. The National Audit Office said that the Department for Health and Social Care did not complete an “effective programme of year-end stock counts” to assess the quality and quantity of coronavirus-related items, such as lateral flow tests. During the last two financial years, the DHSC reported nearly £15bn of write down costs associated with PPE and other health items. The department estimated that the continuing cost of storage and disposal of excess and unusable equipment stands at £319mn. The watchdog found a “lack of adequate governance, oversight and control” at the UKHSA. It noted that due to a “lack of sufficient, appropriate audit evidence and significant shortcomings in financial control” the NAO was unable to provide an audit opinion on the 2021-22 accounts of the agency. Read full story (paywalled) Source: Financial Times, 27 January 2023
  20. Content Article
    Staying active is important if you’re waiting for or recovering from surgery. If you’re fit and strong, your surgery has the best chance of success, and you’ll likely recover quicker. Over time, exercise can also increase your mobility, help your balance and boost your mood.  In this Surgery Toolkit you'll find tailor-made, follow-along exercise routines for hip, shoulder and knee replacement, as well as full body workouts to help you maintain overall fitness.   You can also explore personal stories and advice from those living with arthritis who have been through joint replacement surgery, and tips on keeping active from a physiotherapist. 
  21. News Article
    Children came to “significant” harm due to chronically low staffing levels at scandal-hit mental health hospitals, whistleblowers have said. In a third exposé into allegations of poor care at private hospitals run by The Huntercombe Group, former employees have claimed that staffing levels were so low “every day” that patients were neglected, resulting in: Patients as young as 13 being force-fed while restrained. Left alone to self-harm instead of being supervised. Left to “wet themselves” because staff couldn’t supervise toilet visits. One staff member, Rebecca Smith, said she was left in tears after having to restrain and force-feed a patient. Following a series of investigations by The Independent and Sky News, 50 patients came forward with allegations of “systemic abuse” and poor care, spanning two decades at children’s mental health hospitals run by the organisation. The government has since launched a “rapid review” into inpatient mental health units across the country following the newspaper’s reporting. Read full story Source: The Independent, 28 January 2023
  22. Content Article
    Whether it is the waiting lists for mental health support or the inadequacies of long-Covid clinics, millions of patients with long-term health conditions have been struggling for years to get basic healthcare. The chaotic decline that has befallen acute care in A&E has hit day-to-day services, with effects from delayed consultant appointments and year-long clinic waiting lists to slashed community care. Mental health bed shortages mean young people need now to have “attempted suicide several times” before they get a place in an inpatient unit in England. Record delays for cancer treatment are leaving patients facing lethal waits. Thousands of people with neurological conditions are waiting up to two years to even see a consultant. For them, the ground has long been shaking. It is just that no one else noticed. The Guardian has spoken to disabled people the length and breadth of England and Wales about their wait for care. For them, the NHS is not an “in case of emergency” service but the engine they rely on to keep their day-to-day life running.
  23. Content Article
    The Chartered Institute of Ergonomics and Human Factors (CIEHF) have put together this short video to give you an idea of where to start when asked the question of what ergonomics is.
  24. News Article
    The NHS in England is set to have a major conditions strategy to help determine policy for the care of increasing numbers of people in England with complex and often multiple long-term conditions. Conditions covered by the strategy will include cardiovascular disease, chronic respiratory disease, dementia, mental health conditions, and musculoskeletal disorders. Cancer will also be included and will no longer have its own dedicated 10 year strategy. England’s health and social care secretary, Steve Barclay, told the House of Commons on 24 January that the strategy would build on measures in the NHS long term plan. Read full story (paywalled) Source: BMJ, 25 January 2023
  25. News Article
    The impetus to tackle health security has started to “melt away”, despite the devastation wrought by the Covid pandemic, Tony Blair has warned. In the foreword to a new book, ‘Disease X’, the former British prime minister said that while there are “concurrent crises jostling for the attention of governments”, leaders should not miss the opportunity to implement the “hard-won lessons” of the past three years. “Covid-19 was an unprecedented global crisis and should mark a turning point in global health policy and preparedness,” Mr Blair wrote. “Our governments need to demonstrate the same level of political will, ambition and international cooperation that leaders demonstrated in the wake of World War II, when they coalesced around the objective of a sustainable peace. “This must be applied to the post pandemic order because, at its heart, health security is national security,” he added. “It is clear this will not be the last pandemic threat of our lifetimes … there is no excuse to be unprepared, again.” Read full story (paywalled) Source: The Telegraph, 25 January 2023
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